Health IT, Policy

N.Y. state mandate for e-Rx of controlled substances takes effect; What’s the climate like?

The New York law is meant to cut down on prescription drug abuse and drug diversion by doctors and patients alike.

prescription drugs

After a year’s delay, electronic prescribing of controlled substances — and all prescription drugs — becomes mandatory in New York state on Sunday. It’s the first state to have such a law that’s actually enforceable.

“Minnesota mandated it in 2010, but there’s no enforcement [mechanism],” noted Dr. Peter Kaufman, CMO of e-prescribing technology vendor DrFirst.

The New York law is meant to cut down on prescription drug abuse and drug diversion by doctors and patients alike. In fact, the mechanism is called I-STOP, for Internet System for Tracking Over-Prescribing. It’s part of the state’s official prescription drug monitoring program.

Since 2013, all prescribers in New York have had to check the state drug monitoring program and review patient medical histories before prescribing any controlled substances. They can do this through the I-STOP website or via an EHR or e-prescribing system that has the querying built in.

Despite the earlier requirement and the delay on the EPCS mandate, many are scrambling to comply. Kaufman said that Rockville, Maryland-based DrFirst has gotten numerous calls even this week from practices that have not turned on e-prescribing technology at all.

“I would say we will get calls for another month,” added Stuart Ballat, DrFirst’s marketing vice president.

The national Meaningful Use electronic health records incentive program does require limited e-prescribing. But Kaufman noted that many physicians in New York City in particular do not accept insurance, and thus don’t participate in Meaningful Use, which is tied to Medicare and Medicaid.

While there are some free and standalone e-prescribing systems out there, plenty of physicians have stuck with paper for prescriptions and medical records alike. “I think a lot of naysayers just didn’t want to use computers,” Kaufman said.

Another factor is that EPCS is still relatively new. It was not until 2010 that the Drug Enforcement Agency legalized e-prescribing of Schedule II-V drugs, with several conditions put in place to appease law enforcement. Notably, EPCS software must have two-factor user authentication.

It took five more years for every state to change prescribing regulations and for technology vendors to develop systems that complied with the DEA rules. Last summer, Vermont became the last state to legalize EPCS.

DrFirst’s internal data showed that 80 percent of U.S retail pharmacies had the technology to accept electronic scripts for controlled drugs in 2015. That up 21 points over the previous year. New York is now at 96 percent.

“The pharmacies are all taking EPCS now,” Kaufman said. “That’s made e-prescribing a lot more palatable to doctors.”

Photo: Flickr user Joe Thorn

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